Mass Learning, Spaced Learning, MicrosurgeryNCT03626025
Randomized Prospective Study Comparing the Effectiveness of Massed and Spaced Learning in Microsurgical Procedures
A study testing Spaced learning in people with Mass Learning, Spaced Learning, Microsurgery, run by Hand & Reconstructive Microsurgery.
Trial summary
Title: Randomized prospective study comparing the effectiveness of spaced learning to mass learning in microsurgical procedures. Background: Spacing phenomenon occurs when learning outcomes are greater with the teaching process spread out over time (spaced learning), as opposed to having the same total duration of… Read more about this study
- Who is it for?
- Ages 21 to 26 yearsHealthy volunteers can take part
- Conditions the study is for
- Mass Learning, Spaced Learning, Microsurgery
- What is being tested?
- Spaced learning
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 42 participants
- Where
- No sites listed yet
- Study dates
- 1 Jan 2017to 30 Mar 2017
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 21 to 26 years
- All sexes
- Healthy volunteers accepted
- Adult
Who may be able to join
- Medical students
Who cannot join
- Anyone who has been exposed to any form of microsurgical training
About this study
Title: Randomized prospective study comparing the effectiveness of spaced learning to mass learning in microsurgical procedures.
Background:
Read more
Spacing phenomenon occurs when learning outcomes are greater with the teaching process spread out over time (spaced learning), as opposed to having the same total duration of teaching carried out over a single session (mass learning). Spaced learning has been shown to improve explicit memory tasks including free recall, recognition, cued -recall and frequency estimation. It has been used in various medical specialties with promising results and has been shown to be at least as good as mass training in learning clinical skills such as cardio-pulmonary resuscitation and laparoscopy skills.
We aim to test the concept of spaced learning in learning delicate and complex skilled procedures like microsurgery. Our hypothesis is that spaced learning is better than mass learning in acquiring microsurgical suturing skills.
Methodology:
Medical students with no prior exposure to microsurgical training were randomized into control (mass-learning) and treatment (spaced learning) groups. The students were all taught to handle microsurgical instruments and to suture a prefabricated 4mm wide elastic strip under the microscope using Digital Surgicals MicroTrainer. The control group was taught continuously over 8hrs while the treatment group was taught in 2-hour sessions held each week over a span of 4 weeks. The learning outcomes that were measured included duration taken as well as the placement of the sutures in relation to each other, with the latter being objectively assessed with the use of a computer program from Digital Surgicals. In addition to being assessed at the beginning of the sessions, all participants completed another test 1 month after the completion of the sessions.
- Being tested
- Spaced learning
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Spaced learningOther
Instead of learning over a single session, teaching is carried out over a few weekly sessions but maintaining the overall total number of hours spent on teaching
| Study group | Role | What they receive |
|---|---|---|
| Mass Learning Group | No intervention | Participants underwent an eight-hour microsurgery training course in a single session under the mass-learning format. |
| Spaced Learning Group | Other | Participants underwent two-hour microsurgery training sessions every week for a total of 4 sessions under the spaced learning format. Receives: Other: Spaced learning |
What is being measured
The primary outcome is the main question the study is designed to answer.
Duration
Duration taken to place pre-determined number of sutures on elastic strip
Measured: For the mass learning group, at the end of the 1-day teaching session; for the spaced learning group, at the end of 1 month of teaching sessions.
Suture density and alignment
Another primary outcome measure is the objective scoring of the placement of sutures using a computer program from Digital Surgicals. In particular, the alignment and spacing of the sutures in relation to each other were assessed.
Measured: For the mass learning group, at the end of the 1-day teaching session; for the spaced learning group, at the end of 1 month of teaching sessions.
Secondary outcomes (2)
Retention of skills - assessing duration
Duration taken to place pre-determined number of sutures on elastic strip - to assess retention of skills at 1 month after the completion of teaching sessions.
Measured: 1 month after the end of the final teaching session
Retention of skills - assessing suture density and alignment
Assess retention of skills by assessing the suture density and alignment at 1 month after the completion of teaching sessions.
Measured: 1 month after the end of the final teaching session
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted10 Aug 2018
- Study start1 Jan 2017
- Primary completion28 Feb 2017
- Study completion30 Mar 2017
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (17)Papers the sponsor has linked to this study.
- Other trials for Mass Learning, Spaced Learning, MicrosurgeryStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Other
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 42 participants (actual)
Sponsor and investigators
- Lead sponsor
- Hand & Reconstructive Microsurgery
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor-investigator, Hand & Reconstructive Microsurgery, National University Hospital, Singapore
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03626025
- Sponsor's protocol ID
- 2016/01133
- Other IDs
- 2016
- Status last verified
- Aug 2018
- First submitted
- 24 Jun 2018
- Last updated
- 10 Aug 2018
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Bjork RA: Retrieval practice and the maintenance of knowledge. In: Practical Aspects of Memory: Current Research and Issues. Edited by MM Gruneberg, PE Morris and RN Sykes. New York: John Wiley & Sons 1988; pp 396-401.
Barsuk JH, Cohen ER, McGaghie WC, Wayne DB. Long-term retention of central venous catheter insertion skills after simulation-based mastery learning. Acad Med. 2010 Oct;85(10 Suppl):S9-12. doi: 10.1097/ACM.0b013e3181ed436c.
PubMed 20881713Boettcher M, Boettcher J, Mietzsch S, Krebs T, Bergholz R, Reinshagen K. The spaced learning concept significantly improves training for laparoscopic suturing: a pilot randomized controlled study. Surg Endosc. 2018 Jan;32(1):154-159. doi: 10.1007/s00464-017-5650-6. Epub 2017 Jun 22.
PubMed 28643052Brewster LP, Risucci DA, Joehl RJ, Littooy FN, Temeck BK, Blair PG, Sachdeva AK. Management of adverse surgical events: a structured education module for residents. Am J Surg. 2005 Nov;190(5):687-90. doi: 10.1016/j.amjsurg.2005.07.003.
PubMed 16226940Bridges M, Diamond DL. The financial impact of teaching surgical residents in the operating room. Am J Surg. 1999 Jan;177(1):28-32. doi: 10.1016/s0002-9610(98)00289-x.
PubMed 10037304Cecilio-Fernandes D, Cnossen F, Jaarsma DADC, Tio RA. Avoiding Surgical Skill Decay: A Systematic Review on the Spacing of Training Sessions. J Surg Educ. 2018 Mar-Apr;75(2):471-480. doi: 10.1016/j.jsurg.2017.08.002. Epub 2017 Aug 24.
PubMed 28843958Glenberg AM, Lehmann TS. Spacing repetitions over 1 week. Mem Cognit. 1980 Nov;8(6):528-38. doi: 10.3758/bf03213772. No abstract available.
PubMed 7219173Kerfoot BP, Fu Y, Baker H, Connelly D, Ritchey ML, Genega EM. Online spaced education generates transfer and improves long-term retention of diagnostic skills: a randomized controlled trial. J Am Coll Surg. 2010 Sep;211(3):331-337.e1. doi: 10.1016/j.jamcollsurg.2010.04.023. Epub 2010 Jul 13.
PubMed 20800189Kerfoot BP. Learning benefits of on-line spaced education persist for 2 years. J Urol. 2009 Jun;181(6):2671-3. doi: 10.1016/j.juro.2009.02.024. Epub 2009 Apr 16.
PubMed 19375095Lahiri A, Sebastin SJ, Yusoff SK, Sze Chong AK. Computer Aided Assessment in Microsurgical Training. J Hand Surg Asian Pac Vol. 2016 Jun;21(2):212-21. doi: 10.1142/S2424835516500211.
PubMed 27454636McGaghie WC, Issenberg SB, Petrusa ER, Scalese RJ. A critical review of simulation-based medical education research: 2003-2009. Med Educ. 2010 Jan;44(1):50-63. doi: 10.1111/j.1365-2923.2009.03547.x.
PubMed 20078756Moulton CA, Dubrowski A, Macrae H, Graham B, Grober E, Reznick R. Teaching surgical skills: what kind of practice makes perfect?: a randomized, controlled trial. Ann Surg. 2006 Sep;244(3):400-9. doi: 10.1097/01.sla.0000234808.85789.6a.
PubMed 16926566Pashler H, Rohrer D, Cepeda NJ, Carpenter SK. Enhancing learning and retarding forgetting: choices and consequences. Psychon Bull Rev. 2007 Apr;14(2):187-93. doi: 10.3758/bf03194050.
PubMed 17694899Patocka C, Khan F, Dubrovsky AS, Brody D, Bank I, Bhanji F. Pediatric resuscitation training-instruction all at once or spaced over time? Resuscitation. 2015 Mar;88:6-11. doi: 10.1016/j.resuscitation.2014.12.003. Epub 2014 Dec 13.
PubMed 25511519Spruit EN, Band GP, Hamming JF. Increasing efficiency of surgical training: effects of spacing practice on skill acquisition and retention in laparoscopy training. Surg Endosc. 2015 Aug;29(8):2235-43. doi: 10.1007/s00464-014-3931-x. Epub 2014 Oct 16.
PubMed 25318372
Study at a glance
From the registry record, last updated by the sponsor on 10 Aug 2018. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Randomized Prospective Study Comparing the Effectiveness of Massed and Spaced Learning in Microsurgical Procedures
- ClinicalTrials.gov ID
- NCT03626025
- Acronym / sponsor ID
- 2016/01133
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 42 participants (actual)
- Lead sponsor
- Hand & Reconstructive MicrosurgeryUniversity, hospital or other
- Study start
- 1 Jan 2017 (actual)
- Primary completion
- 28 Feb 2017 (actual)
- Study completion
- 30 Mar 2017 (actual)
- First posted
- 10 Aug 2018 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Title: Randomized prospective study comparing the effectiveness of spaced learning to mass learning in microsurgical procedures.
Background:
Spacing phenomenon occurs when learning outcomes are greater with the teaching process spread out over time (spaced learning), as opposed to having the same total duration of teaching carried out over a single session (mass learning). Spaced learning has been shown to improve explicit memory tasks including free recall, recognition, cued -recall and frequency estimation. It has been used in various medical specialties with promising results and has been shown to be at least as good as mass training in learning clinical skills such as cardio-pulmonary resuscitation and laparoscopy skills.
We aim to test the concept of spaced learning in learning delicate and complex skilled procedures like microsurgery. Our hypothesis is that spaced learning is better than mass learning in acquiring microsurgical suturing skills.
Methodology:
Medical students with no prior exposure to microsurgical training were randomized into control (mass-learning) and treatment (spaced learning) groups. The students were all taught to handle microsurgical instruments and to suture a prefabricated 4mm wide elastic strip under the microscope using Digital Surgicals MicroTrainer. The control group was taught continuously over 8hrs while the treatment group was taught in 2-hour sessions held each week over a span of 4 weeks. The learning outcomes that were measured included duration taken as well as the placement of the sutures in relation to each other, with the latter being objectively assessed with the use of a computer program from Digital Surgicals. In addition to being assessed at the beginning of the sessions, all participants completed another test 1 month after the completion of the sessions.
Study design
- Primary purpose
- Other
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Mass Learning Group | No intervention | –Participants underwent an eight-hour microsurgery training course in a single session under the mass-learning format. |
| Spaced Learning Group | Other | Other: Spaced learningParticipants underwent two-hour microsurgery training sessions every week for a total of 4 sessions under the spaced learning format. |
Who may qualify
- Ages
- 21 to 26 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult
Key inclusion criteria (1 listed)
- Medical students
Key exclusion criteria (1 listed)
- Anyone who has been exposed to any form of microsurgical training
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Spaced learningInstead of learning over a single session, teaching is carried out over a few weekly sessions but maintaining the overall total number of hours spent on teaching | Other | Spaced Learning Group |
Primary outcome
Duration
Time frame: For the mass learning group, at the end of the 1-day teaching session; for the spaced learning group, at the end of 1 month of teaching sessions.
Duration taken to place pre-determined number of sutures on elastic strip
Suture density and alignment
Time frame: For the mass learning group, at the end of the 1-day teaching session; for the spaced learning group, at the end of 1 month of teaching sessions.
Another primary outcome measure is the objective scoring of the placement of sutures using a computer program from Digital Surgicals. In particular, the alignment and spacing of the sutures in relation to each other were assessed.
2 secondary outcomes
Retention of skills - assessing duration
Time frame: 1 month after the end of the final teaching session
Retention of skills - assessing suture density and alignment
Time frame: 1 month after the end of the final teaching session
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 10 Aug 2018.
- BackgroundBjork RA: Retrieval practice and the maintenance of knowledge. In: Practical Aspects of Memory: Current Research and Issues. Edited by MM Gruneberg, PE Morris and RN Sykes. New York: John Wiley & Sons 1988; pp 396-401.
- Background: PubMed 20881713Barsuk JH, Cohen ER, McGaghie WC, Wayne DB. Long-term retention of central venous catheter insertion skills after simulation-based mastery learning. Acad Med. 2010 Oct;85(10 Suppl):S9-12. doi: 10.1097/ACM.0b013e3181ed436c.
- Background: PubMed 28643052Boettcher M, Boettcher J, Mietzsch S, Krebs T, Bergholz R, Reinshagen K. The spaced learning concept significantly improves training for laparoscopic suturing: a pilot randomized controlled study. Surg Endosc. 2018 Jan;32(1):154-159. doi: 10.1007/s00464-017-5650-6. Epub 2017 Jun 22.
- Background: PubMed 16226940Brewster LP, Risucci DA, Joehl RJ, Littooy FN, Temeck BK, Blair PG, Sachdeva AK. Management of adverse surgical events: a structured education module for residents. Am J Surg. 2005 Nov;190(5):687-90. doi: 10.1016/j.amjsurg.2005.07.003.
- Background: PubMed 10037304Bridges M, Diamond DL. The financial impact of teaching surgical residents in the operating room. Am J Surg. 1999 Jan;177(1):28-32. doi: 10.1016/s0002-9610(98)00289-x.
- Background: PubMed 28843958Cecilio-Fernandes D, Cnossen F, Jaarsma DADC, Tio RA. Avoiding Surgical Skill Decay: A Systematic Review on the Spacing of Training Sessions. J Surg Educ. 2018 Mar-Apr;75(2):471-480. doi: 10.1016/j.jsurg.2017.08.002. Epub 2017 Aug 24.
- Background: PubMed 7219173Glenberg AM, Lehmann TS. Spacing repetitions over 1 week. Mem Cognit. 1980 Nov;8(6):528-38. doi: 10.3758/bf03213772. No abstract available.
- Background: PubMed 20800189Kerfoot BP, Fu Y, Baker H, Connelly D, Ritchey ML, Genega EM. Online spaced education generates transfer and improves long-term retention of diagnostic skills: a randomized controlled trial. J Am Coll Surg. 2010 Sep;211(3):331-337.e1. doi: 10.1016/j.jamcollsurg.2010.04.023. Epub 2010 Jul 13.
- Background: PubMed 19375095Kerfoot BP. Learning benefits of on-line spaced education persist for 2 years. J Urol. 2009 Jun;181(6):2671-3. doi: 10.1016/j.juro.2009.02.024. Epub 2009 Apr 16.
- Background: PubMed 27454636Lahiri A, Sebastin SJ, Yusoff SK, Sze Chong AK. Computer Aided Assessment in Microsurgical Training. J Hand Surg Asian Pac Vol. 2016 Jun;21(2):212-21. doi: 10.1142/S2424835516500211.
- Background: PubMed 20078756McGaghie WC, Issenberg SB, Petrusa ER, Scalese RJ. A critical review of simulation-based medical education research: 2003-2009. Med Educ. 2010 Jan;44(1):50-63. doi: 10.1111/j.1365-2923.2009.03547.x.
- Background: PubMed 16926566Moulton CA, Dubrowski A, Macrae H, Graham B, Grober E, Reznick R. Teaching surgical skills: what kind of practice makes perfect?: a randomized, controlled trial. Ann Surg. 2006 Sep;244(3):400-9. doi: 10.1097/01.sla.0000234808.85789.6a.
- Individual participant dataSharing planned: No
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
Questions about this trial
What is this clinical trial studying?
A study testing Spaced learning in people with Mass Learning, Spaced Learning, Microsurgery, run by Hand & Reconstructive Microsurgery.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 10 Aug 2018. Status can change between updates, so confirm with the study contact before making plans.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Duration (time frame: For the mass learning group, at the end of the 1-day teaching session; for the spaced learning group, at the end of 1 month of teaching sessions.). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT03626025, which also lists 17 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 10 Aug 2018.